From the Guidelines
The latest treatment for tennis elbow involves a combination of rest, physical therapy, and anti-inflammatory measures, with a focus on eccentric strengthening exercises and relative rest to prevent further damage and promote healing. Initially, rest the affected arm and avoid activities that worsen pain. Apply ice for 15-20 minutes several times daily to reduce inflammation, as cryotherapy is effective for short-term pain relief 1. Over-the-counter NSAIDs like ibuprofen (400-600mg three times daily) or naproxen (220-440mg twice daily) can help manage pain and inflammation for short periods, although they have no effect on long-term outcomes 1. Physical therapy focusing on eccentric strengthening exercises is crucial for recovery; these should be performed 3 sets of 15 repetitions daily, as eccentric strengthening is an effective treatment of tendinopathy and may reverse degenerative changes 1. A counterforce brace worn just below the elbow can reduce strain during daily activities. For persistent cases, corticosteroid injections may provide temporary relief, though they're typically limited to 2-3 injections spaced several weeks apart, as locally injected corticosteroids may be more effective than oral NSAIDs in acute-phase pain relief but do not alter long-term outcomes 1. Most cases improve within 6-12 months with conservative treatment. Tennis elbow results from overuse causing microtears in the tendon that attaches to the lateral epicondyle of the humerus, making proper rehabilitation essential for preventing recurrence.
Some key points to consider in the treatment of tennis elbow include:
- Relative rest and reduced activity to prevent further damage and promote healing 1
- Cryotherapy for acute relief of tendinopathy pain 1
- Eccentric strengthening exercises to reverse degenerative changes 1
- Use of orthotics and braces to reinforce, unload, and protect tendons during activity, although few data support definitive conclusions regarding their effectiveness 1
- Consideration of newer treatments, such as platelet-rich plasma (PRP) injections, for persistent cases.
It's essential to note that the majority of patients with overuse tendinopathies (about 80 percent) fully recover within three to six months, and outpatient treatment should consist of relative rest of the affected area, icing, and eccentric strengthening exercises 1.
From the Research
Treatment Options for Tennis Elbow
The latest treatment for tennis elbow includes a variety of conservative and non-conservative methods. Some of the treatment options are:
- Injection therapies, such as autologous blood and platelet-rich plasma, which have been shown to be effective in treating tennis elbow 2
- Physical therapy, which focuses on pain management, functional recovery, and recurrence prevention 3
- Physiotherapy techniques, such as manual treatments, exercise rehabilitation, and modalities, which can help to reduce pain and improve joint function 3
- Conservative treatment programs, which include relieving inflammation and pain, promoting the healing process, exercises for strength and flexibility, and reducing overload forces 4, 5
Conservative Treatment
Conservative treatment for tennis elbow typically involves a combination of the following steps:
- Relieving inflammation and pain with rest, ice, anti-inflammatory medications, and occasionally cortisone injections 4
- Promoting the healing process with high-voltage galvanic stimulation 4
- Exercises for strength, endurance, and flexibility in the arm and forearm 4
- Reducing the overload forces that caused the original injury by using a counterforce brace and modifying the player's technique and equipment 4
Effectiveness of Treatment Options
The effectiveness of different treatment options for tennis elbow has been studied in various research papers. For example:
- A study found that injection therapies, especially autologous blood and platelet-rich plasma, are effective in treating tennis elbow 2
- Another study found that physical therapy is a crucial component of the treatment of tennis elbow, and that it can help to reduce pain and improve joint function 3
- A review of physiotherapy techniques used in the treatment of tennis elbow found that manual treatments, exercise rehabilitation, and modalities can be effective in reducing pain and improving joint function 3